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Community Partner Update: April 2012

4/9/2012

VR Program Performance Update

DRS continued to make performance gains in the VR program through February 2012. In the first eight months of FY2012, competitive employment outcomes were up 13.4 percent over the same period in the previous fiscal year. The Bureau of Blind Services (BBS) showed a 47.7 percent increase in that time period, while the Bureau of Field Services (BFS) had a 11.7 percent increase. Within BFS, Region 3 had a 26.8 percent increase compared to a year ago.

DRS also increased its performance on the rehabilitation rate measure from 53.1 percent in FY2011 to

55.9 percent in FY2012. The rehab rate is a measure of the percentage of closed cases that resulted in a successful employment outcome for the customer.

DRS made gains on key pre-employment measures as well. Referrals to the VR program were up 7.7 percent compared to last year, with considerable variability among regions and bureaus. BBS showed an increase in referrals of 18.8 percent, while BFS overall had a 7.0 percent increase.

The number of applications for VR services increased by 2.0 percent compared to the previous fiscal year. However, the number of cases certified as eligible for VR services was essentially unchanged from year to year.

The number of new service plans (IPEs) written for VR customers increased by 15.3 percent compared to the previous year. BBS had an increase of 46.8 percent overall, a notable achievement, while BFS as a whole showed an increase of 12.3 percent.

Independent Living

The FY11 Independent Living Annual Report has been finalized and should be ready for distribution shortly.

The need for accessible affordable housing options for people with disabilities is greater today than ever. To that end, the Home First Illinois Program will develop approximately 100 accessible affordable homes/housing units over the next three years. This program has the potential of benefiting approximately 140 people with disabilities. The first phase of the program is starting in Chicago in partnership with Access Living (who will provide referrals) with the goal of rehabbing 18 units within six months.

Legislation

There are a number of measures in the General Assembly that affect, or may affect, the Home Services Program:

House Bill 4177: Amends the Illinois Public Labor Relations Act and the Disabled Persons Rehabilitation Act - adds home care and home health workers, personal care attendants, personal assistants, and maintenance home health workers who work under HSP to the definition of public employee for the purpose of labor relations (regardless of fee-for-service or managed care arrangements). Also indicates the State shall be considered the employer of these individuals.

House Bill 4541: Amends the Disabled Persons Rehabilitation Act to provide that a person is not eligible for employment as a personal assistant under the Home Services Program if that person has been convicted of a felony, has been arrested for a criminal offense, or is an immediate family member of the individual receiving services under the Program. An amendment will change the measure to require criminal history background checks for all personal assistants and individual providers of the Program.

House Bill 5633: Amends the Nursing Home Care Act to require every individual entering a nursing facility to 1) first have consent of a resident, 2) notify the administrator of his or her presence in the facility, 3) request access to residents who have given consent, and 4) provide copies of all informational materials to the administrator prior to visitation with the resident. The measure also provides that a legal guardian appointed for a resident must give prior written approval before access to the resident may be sought and such approval must be presented to the administrator upon entering the facility.

SB 267: Amends the Disabled Persons Rehabilitation Act to add language concerning comparable Medicaid rates between the Home Services Program and the Department on Aging.

SB 1351: Amends the Disabled Persons Rehabilitation Act to make revisions to the Home Services Program's enabling language. The current language is antiquated and not current with today's programmatic standards.

SB 3587: Requires the Department on Aging to implement an exception process in the Community Care Program to allow an individual to exceed his or her service cost maximum if required to prevent institutionalization. Provides that all persons admitted to a nursing home facility who remain in the facility for a period of 30 days shall be rescreened between 30 and 45 days after admittance to assess their continuing need for nursing facility care and shall be advised of all other available care options.

Bureau of Blind Services

The Blind Services Planning Council (BSPC) will host their "Meet & Greet" event in the Hall of Flags at the Office of the Secretary of State. The event will take place on Tuesday, May 1, 2012 from 7:30 a.m. until 12:30 p.m. The purpose of the event is to allow BSPC members an opportunity to lobby with a large number of legislators to discuss the mission and plans of the council. BSPC reviews the actions of the Bureau of Blind Services and provides advice and consultation to the DRS Director on services to persons who are blind.

Home Services Program

The Home Services Program has been working on a series of efforts to improve the efficiency and effectiveness of our processes beginning at the front door. HSP is also are working on various efforts required by the proposed FY 13 budget. Many efficiency and effectiveness efforts are also part of the budget.

Chicago Heights Pilot - Even before the FY13 budget was settled, HSP was in the process of developing a series of reforms geared at making the program more efficient and effective. This includes many of the steps now envisioned in the budget. To help inform this process, HSP has been engaging in a pilot project in Chicago Heights (south suburban Cook County) to test steps and analyze the caseload of one of DRS' larger offices before finalizing things for roll-out statewide. This effort has already been very helpful. HSP believes this effort will improve on their initial plans. It also has been showing HSP additional areas where they can improve program efficiency and customer service.

Intake Triage & Pre-Application Process - Due to staffing problems, field offices have had a difficult time processing all of the applications received. There are backlogs that vary throughout the state. Most offices have some way of determining if an application must be seen immediately. HSP has developed a plan to standardize the list of emergency situations. For other applicants, HSP is taking a page from the Aging Community Care Program to develop a pre-application by mail. Applicants will be prompted to provide information ahead of time. This will allow for both more quality home assessments and more rapid completion of the eligibility determination process in general. These steps are part of our Chicago Heights pilot.

Budget

FY13 Governor's Introduced Budget Details

On February 22, Governor Quinn outlined the details supporting the FY13 Introduced Budget. Illinois, as well as the rest of the nation, is continuing to grapple with a challenging economic climate. As such, spending reductions, facility closures, and program and policy changes are going to be required.

For DRS, this means virtually flat funding from FY12 for all programs. However, in order to manage HSP, significant changes will be required. HSP will be funded $4.2 million below the FY12 allocation and will also be carrying over $12.0 million of FY12 bills into FY13. More specifically, $60.4 million in policy and programmatic changes will also be implemented in order to preserve the integrity of the program and to ensure it will be sustainable to those who need it in the foreseeable future.

The eligibility threshold, as assessed by the Determination of Need (DON), will be increased from 29 to 37. This change will impact approximately 1,500 new applicants, not existing customers. A new eligibility tool will be selected and implemented as soon as practical. Existing customers who continue to receive at least 29 points on the DON will remain eligible until they are reassessed for eligibility on the new tool or until some other transition plan is completed based on a Medicaid waiver amendment.

The Service Cost Maximums for customers with DON scores between 29 and 39 will be decreased to be more consistent with the Department on Aging's Community Care Program. This may reduce services to up to 14,000 customers.

Individuals with a diagnosis of mental illness or developmental disabilities who do not qualify for HSP based on their physical disabilities will not be eligible for HSP. This will assure the program is administered as originally intended and in compliance with its Medicaid waivers. The change will impact approximately 400 new applicants. There will be no long term grandfathering. HSP is working with the Divisions of Developmental Disabilities and Mental Health to provide transitions for existing customers who qualify for the services provided by those programs.

With the exception of Respite, services to individuals under the age of 18 will be eliminated. This change will impact up to 1,300 customers. No one will be grandfathered.

Individuals in the Brain Injury Waiver who do not need a specialized service will be transitioned to the Persons with Disabilities Waiver. This change will impact approximately 3,000 customers. This will not result in any changes in the amount of direct care received.

The provider payment process will be tightened by piloting a new time sheet. In addition, payments will no longer be made to providers who do not complete a Medicaid Provider Enrollment Form (1413).

The use of Interim services will be limited to emergencies, as was the case until relatively recently, to assure program eligibility requirements are met. Interim eligibility also will be time limits.

In addition, funding of HSP will be modified. Historically the program has been funded with General Revenue Funds (GRF). The program will now be dually funded (approximately 60/40), with $329.3 million of the program's $569.3 allocation coming from GRF, and $240.0 million from a newly developed Medicaid Trust Fund. The Medicaid Trust Fund will be pivotal to the HSP because funding is garnered from the Medicaid reimbursement. The program generates from Medicaid eligible expenditures. This means we will be tightly enforcing completion of the 1413 in order to ensure enough funding is generated to support the program.

While this is the very beginning of the FY13 budget process, DRS is confident we can continue to provide a quality investment in the services for individuals with disabilities in Illinois.

Bureau of Field Services

The need to coordinate services for our returning soldiers has never been needed more than now. DRS has developed a Memorandum of Understanding (MOU) with the federal Veteran's Administration that will allow DRS to act as case manager for soldiers needing Home Services and Vocation Rehabilitation Services. This agreement will initially serve customers in the Chicago area and eventually expand to the rest of Illinois. The benefit will be to those soldiers who need the services and the expertise that DRS can provide to them with the federal government paying for the services.

Training Division: Spring is the time for growth, and attending conferences is an excellent way to gain knowledge and insight into new developments in the areas of Vocational Rehabilitation and opportunities in Government. In addition to developing and conducting training events for DRS staff, the Training Unit also works with statewide organizations to facilitate attendance of DRS staff at major annual conferences. This spring DRS is working with three organizations to support attendance at their conferences: the Illinois Rehabilitation Association (IRA); the Illinois Association of Agencies and Community Organizations for Migrant Advocacy (IAACOMA); and the Illinois Association of Minorities in Government (IAMG).